Wang D, Li ZS, Zhang WJ, Pan X, Sun ZX, Zou XP. Value and safety of ERCP and endoscopic treatment for acute biliary pancreatitis.
Shijie Huaren Xiaohua Zazhi 2003;
11:1550-1553. [DOI:
10.11569/wcjd.v11.i10.1550]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM
To evaluate the value and safety of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic treatment in acute biliary pancreatitis.
METHODS
Ninety-one patients with acute biliary pancreatitis including 13 patients with severe acute biliary pancreatitis in the ERCP group underwent ERCP and endoscopic therapy. 15 patients with severe acute biliary pancreatitis were not treated by either surgery, endoscopy or early ERCP in the control group. Etiological factors, therapeutic effects and complications were observed in all the patients of the two groups.
RESULTS
In ERCP group, ERCP showed biliary tract disease in 56 cases, common bile duct stones in 26, cholecyst stone in 17, microcholelith in 4, cholangitis in 9, larger diverticula around the papilla in 3, papillitis in 5, pancreatic diverticulum in 2, and normal in 25. 46 cases of biliary tract disease were treated by endoscopy including papillosphincterotomy, endoscopic nasal biliary drainage and endoscopic dilatation of the accessory papilla. There were no significant differences in the recovery days of serum amylase back to normal between ERCP group (3.4±1.6 d) and control group (4.5±2.8 d), but the mean days of disappearance of abdominal pain (4.4±2.0 d), fever (5.0±3.4 d), abnormal white blood cell count (6.5±5.4 d) and hospitalization (21.9±8.4 d) were significantly shorter in the ERCP group than in the control group (8.4±6.1 d, 16.1±19.0 d, 19.1±19.3 d, 41.3±20.0 d, P<0.05). Complication rate (53.9%) and mortality rate (0%) in ERCP group were lower than those of control group (80.0%, 23.1% P<0.05). 17 cases had early complication (18.7%) in ERCP group. Of them, biliary tract infection occurred in 2 cases (2.2%), retroperitoneal pneumatosis in 1 case (1.1%), bleeding of digestive tract in 1 case (1.1%), deterioriation of pancreatitis in 13 cases. 15 patients were cured by medication treatment. Operations were performed in one patient. One patient died.
CONCLUSION
ERCP and endoscopic therapy are safe and effective for patients with acute pancreatitis.
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